Nokea
The nurse is providing teaching to a post-valve replacement client. Which activit(ies) would require prophylactic antibiotic use? Select all that apply.
- A. Vision screening
- B. Dental care
- C. Echocardiogram
- D. MRI
- E. Colonoscopy
- F. Chelation therapy
Correct Answer: B,E
Rationale: Dental cleaning/care and colonoscopy are invasive procedures that can disturb the normal bacteria located in residence and place a valve replacement client at risk for infective endocarditis. Vision screening, echocardiogram, MRI, and chelation therapy are not invasive procedures and do not mobilize bacteria.
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The client is complaining of severe dizziness and drowsiness. Upon assessment, the nurse finds the client has bradycardia and a bluish discoloration of the palms and fingernails. What do these signs and symptoms indicate?
- A. Cinchonism
- B. Overdosage
- C. Hypokalemia
- D. Hypertension
Correct Answer: B
Rationale: These signs and symptoms indicate overdosage of a drug. The nurse should inform the care provider immediately if these symptoms appear. These are not the signs and symptoms of cinchonism, hypokalemia, or hypertension.
The nursing instructor is teaching the junior nursing students about aortic regurgitation. What classification of drugs is used to sustains the client with aortic regurgitation?
- A. Antihypertensives
- B. Anticoagulants
- C. Cardiac glycosides
- D. Antiarrhythmics
Correct Answer: C
Rationale: Because aortic regurgitation is mild and only slowly progressive in most people, clients are sustained with cardiac glycosides or beta-blockers and diuretics. Antihypertensives, anticoagulants, and antiarrhythmics are not the type of drugs used to treat aortic regurgitation.
The nurse is interviewing a client who is being admitted for possible mitral regurgitation. Which historical fact is of greatest value to the nurse?
- A. Congenital neural tube defect
- B. Rheumatic fever
- C. One-pack-a-day smoker for 20 years
- D. Pacemaker inserted 2 years ago
Correct Answer: B
Rationale: Rheumatic fever and subsequent heart disease is the prominent cause of valvular insufficiency. Congenital neural tube defect is associated with spina bifida not mitral regurgitation. Smoking and insertion of pacemaker are significant to heart disorders but not of greatest value as rheumatic fever.
A client with progressive mitral valve prolapse is experiencing sympathetic nervous system symptoms in addition to prolapse symptoms. Which teaching point should be stressed by the nurse to minimize these effects?
- A. Antibiotic therapy before invasive procedures
- B. Low-dose aspirin daily
- C. Avoid caffeine.
- D. Decrease fluid and sodium intake.
Correct Answer: C
Rationale: The symptoms associated with sympathetic nervous response (anxiety, agitation, nervousness, and palpitations) are often managed with antianxiety medications and advisement to avoid caffeine and over-the-counter medications that contain stimulants. Periodic antibiotic therapy use before an invasive procedure is not associated with sympathetic nervous system symptoms. Low-dose aspirin is used to prevent thrombus formation. Decreasing fluid and sodium intake is indicated for the control of congestive failure.
The nurse is caring for a client with a valvular disorder. The client is at risk for decreased cardiac output. What nursing intervention should a nurse perform for this client?
- A. Perform exercises consistently.
- B. Keep legs horizontal.
- C. Auscultate lung and heart sounds.
- D. Measure urine output.
Correct Answer: D
Rationale: The nurse should monitor urine output every 8 hours or more often if it is less than 500 mL/day. Renal output reflects the heart's ability to perfuse the renal arteries. The client should not perform any exercises and should be on bed rest. Keeping the client's legs horizontal and auscultating lung and heart sounds will not help in this condition.